{"title":"主动脉瓣狭窄患者的红细胞分布宽度与全因死亡率之间的关系:一项回顾性研究","authors":"Benhui Liang , Yiyang Tang , Shien Li , Xinyi Zhou , Mukamengjiang Juaiti , Lihuang Zha , Zaixin Yu , Meijuan Wang , Yilu Feng","doi":"10.1016/j.hrtlng.2024.04.020","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>It is essential to assess the risk stratification of patients with aortic stenosis (AS).</p></div><div><h3>Objective</h3><p>To clarify the predictive value of red blood cell distribution width (RDW) in AS patients using a large cohort from the MIMIC-IV database.</p></div><div><h3>Methods</h3><p>Restricted cubic spline, the Kaplan-Meier method, and logistic and Cox regression analyses were used to explore the association between RDW and all-cause mortality in AS patients. Multivariate adjustments, propensity score matching and weighting, and subgroup analysis were conducted to exclude confounding factors. Receiver operating characteristic (ROC) and decision curve analysis (DCA) curves were drawn to evaluate the predictive performance of RDW.</p></div><div><h3>Results</h3><p>1,148 patients with AS were included. Their death risks gradually increased with the elevation of RDW. Multivariate-adjusted 90-day (OR: 2.12; HR: 1.90; <em>p</em> = 0.001) and 1-year (OR: 2.07; HR: 1.97; <em>p</em> < 0.001) all-cause mortalities were significantly higher in patients with RDW≥14.7 %, which remained robust after propensity score matching and subgroup analysis. For AS patients with high RDW, those < 75 years old had higher death risks than those ≥ 75 years old. The area under the ROC curve of RDW were 0.741 and 0.75 at 90-day and 1-year follow-ups, respectively, exhibiting comparable performance to acute physiology score III and outperforming other critical illness scores in predicting the prognosis of AS patients. DCA curves also illustrated that RDW had a wide range of net benefits.</p></div><div><h3>Conclusions</h3><p>High RDW was independently associated with increased 90-day and 1-year all-cause mortalities of AS patients, with strong predictive capability of prognosis.</p></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":null,"pages":null},"PeriodicalIF":2.4000,"publicationDate":"2024-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association between red blood cell distribution width and the all-cause mortality of patients with aortic stenosis: A retrospective study\",\"authors\":\"Benhui Liang , Yiyang Tang , Shien Li , Xinyi Zhou , Mukamengjiang Juaiti , Lihuang Zha , Zaixin Yu , Meijuan Wang , Yilu Feng\",\"doi\":\"10.1016/j.hrtlng.2024.04.020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>It is essential to assess the risk stratification of patients with aortic stenosis (AS).</p></div><div><h3>Objective</h3><p>To clarify the predictive value of red blood cell distribution width (RDW) in AS patients using a large cohort from the MIMIC-IV database.</p></div><div><h3>Methods</h3><p>Restricted cubic spline, the Kaplan-Meier method, and logistic and Cox regression analyses were used to explore the association between RDW and all-cause mortality in AS patients. Multivariate adjustments, propensity score matching and weighting, and subgroup analysis were conducted to exclude confounding factors. Receiver operating characteristic (ROC) and decision curve analysis (DCA) curves were drawn to evaluate the predictive performance of RDW.</p></div><div><h3>Results</h3><p>1,148 patients with AS were included. Their death risks gradually increased with the elevation of RDW. Multivariate-adjusted 90-day (OR: 2.12; HR: 1.90; <em>p</em> = 0.001) and 1-year (OR: 2.07; HR: 1.97; <em>p</em> < 0.001) all-cause mortalities were significantly higher in patients with RDW≥14.7 %, which remained robust after propensity score matching and subgroup analysis. For AS patients with high RDW, those < 75 years old had higher death risks than those ≥ 75 years old. The area under the ROC curve of RDW were 0.741 and 0.75 at 90-day and 1-year follow-ups, respectively, exhibiting comparable performance to acute physiology score III and outperforming other critical illness scores in predicting the prognosis of AS patients. DCA curves also illustrated that RDW had a wide range of net benefits.</p></div><div><h3>Conclusions</h3><p>High RDW was independently associated with increased 90-day and 1-year all-cause mortalities of AS patients, with strong predictive capability of prognosis.</p></div>\",\"PeriodicalId\":55064,\"journal\":{\"name\":\"Heart & Lung\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-05-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Heart & Lung\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0147956324000840\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Heart & Lung","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0147956324000840","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景:评估主动脉瓣狭窄(AS)患者的风险分层至关重要:评估主动脉瓣狭窄(AS)患者的风险分层至关重要:利用 MIMIC-IV 数据库中的大型队列,明确红细胞分布宽度(RDW)对 AS 患者的预测价值:方法:采用限制立方样条法、Kaplan-Meier法、逻辑回归分析和Cox回归分析来探讨RDW与强直性脊柱炎患者全因死亡率之间的关系。为排除混杂因素,进行了多变量调整、倾向评分匹配和加权以及亚组分析。绘制了接收者操作特征(ROC)和决策曲线分析(DCA)曲线,以评估RDW的预测性能:结果:共纳入 1,148 例 AS 患者。他们的死亡风险随着RDW的升高而逐渐增加。多变量调整后的 90 天(OR:2.12;HR:1.90;p = 0.001)和 1 年(OR:2.07;HR:1.97;p < 0.001)全因死亡率在 RDW≥14.7% 的患者中明显更高,经过倾向得分匹配和亚组分析后,这一结果仍然很可靠。对于RDW较高的强直性脊柱炎患者,年龄小于75岁的患者的死亡风险高于年龄≥75岁的患者。在90天和1年随访中,RDW的ROC曲线下面积分别为0.741和0.75,在预测强直性脊柱炎患者的预后方面表现与急性生理学评分III相当,优于其他危重症评分。DCA曲线还表明,RDW具有广泛的净效益:结论:高RDW与强直性脊柱炎患者90天和1年全因死亡率增加有独立关联,对预后有很强的预测能力。
Association between red blood cell distribution width and the all-cause mortality of patients with aortic stenosis: A retrospective study
Background
It is essential to assess the risk stratification of patients with aortic stenosis (AS).
Objective
To clarify the predictive value of red blood cell distribution width (RDW) in AS patients using a large cohort from the MIMIC-IV database.
Methods
Restricted cubic spline, the Kaplan-Meier method, and logistic and Cox regression analyses were used to explore the association between RDW and all-cause mortality in AS patients. Multivariate adjustments, propensity score matching and weighting, and subgroup analysis were conducted to exclude confounding factors. Receiver operating characteristic (ROC) and decision curve analysis (DCA) curves were drawn to evaluate the predictive performance of RDW.
Results
1,148 patients with AS were included. Their death risks gradually increased with the elevation of RDW. Multivariate-adjusted 90-day (OR: 2.12; HR: 1.90; p = 0.001) and 1-year (OR: 2.07; HR: 1.97; p < 0.001) all-cause mortalities were significantly higher in patients with RDW≥14.7 %, which remained robust after propensity score matching and subgroup analysis. For AS patients with high RDW, those < 75 years old had higher death risks than those ≥ 75 years old. The area under the ROC curve of RDW were 0.741 and 0.75 at 90-day and 1-year follow-ups, respectively, exhibiting comparable performance to acute physiology score III and outperforming other critical illness scores in predicting the prognosis of AS patients. DCA curves also illustrated that RDW had a wide range of net benefits.
Conclusions
High RDW was independently associated with increased 90-day and 1-year all-cause mortalities of AS patients, with strong predictive capability of prognosis.
期刊介绍:
Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders.
The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.